title: Treatment of bronchiolitis: state of the art.
abstract: Bronchiolitis is a leading cause of acute illness and hospitalization for infants and young children worldwide. It is usually a mild disease, but the few children developing severe symptoms need to be hospitalized and some will need ventilatory support. To date, the mainstay of therapy has been supportive care, i.e. assisted feeding and hydration, minimal handling, nasal suctioning and oxygen therapy. In recent years the delivery of oxygen has been improved by using a high-flow nasal cannula. At the same time, the discovery of nebulized hypertonic saline enables better airway cleaning with a benefit for respiratory function. The possible role of any pharmacological approach is still debated: many pharmacological therapies tried in the past, ranging from bronchodilators to corticosteroids, were found to offer no benefit in this disease. More recently, nebulized adrenaline demonstrated a short-term benefit. Prophylaxis and prevention, especially in children at high risk of severe infection, such as prematurely born infants and children with bronchopulmonary dysplasia, have a fundamental role in dealing with this disease. In this review, we focus on current recommendations for the management and prevention of bronchiolitis, paying particular attention to the latest literature in search of answers to the questions that remain open.
authors.affiliation: Women's and Child's Health Department, Unit of Pediatric Respiratory Medicine and Allergy, Unit of Pediatric Emergency Department, University of Padova, Via Giustiniani 3, Padua,Italy.
authors.forename: Liviana
authors.initials: L
authors.lastname: Da Dalt
authors.forename: Silvia
authors.initials: S
authors.lastname: Bressan
authors.forename: Francesco
authors.initials: F
authors.lastname: Martinolli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Perilongo
authors.forename: Eugenio
authors.initials: E
authors.lastname: Baraldi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001988:Bronchiolitis / Q000517:prevention & control / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004750:Enteral Nutrition; D005440:Fluid Therapy; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D009296:Nasal Cavity; D010102:Oxygen Inhalation Therapy; D012462:Saline Solution, Hypertonic; D013396:Suction / Q000379:methods; D007507:Therapeutic Irrigation
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D012462:Saline Solution, Hypertonic